Introduction:
Hemolytic anemia, a form of anemia that causes premature rupture of
erythrocytes, accounts for five percent of anemias[1].
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a well-known
cause of hemolysis and currently affects around 400,000000 individuals
globally. It has a notable prevalence in African, Asian, and
Mediterranean countries [2]. Favism is a common trigger of oxidative
stress in G6PD deficient people, which can lead to hemolysis.
Additionally, fava bean ingestion can cause methemoglobinemia [3].
Methemoglobin is an abnormal variation in the hemoglobin in which the
ferrous (Fe2+) iron in heme is oxidized to the ferric
(Fe3+) state. The condition is usually acquired,
secondary to oxidative stress in the body such as favism or infections,
but can rarely be congenital[4]. The first-line treatment for
methemoglobinemia is methylene blue. However, in G6PD deficient
patients, methylene blue can potentiate hemolysis because of its
oxidative effects [3]. It is vital to take a detailed history of
patients presenting with hemolysis to identify the potential causes and
avoid any additional oxidative stress.